Vesicoureteral reflux


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Vesicoureteral reflux

Renal system

Renal and ureteral disorders

Renal agenesis

Horseshoe kidney

Potter sequence











Renal tubular acidosis

Minimal change disease

Diabetic nephropathy

Focal segmental glomerulosclerosis (NORD)


Membranous nephropathy

Lupus nephritis

Membranoproliferative glomerulonephritis

Poststreptococcal glomerulonephritis

Goodpasture syndrome

Rapidly progressive glomerulonephritis

IgA nephropathy (NORD)

Lupus nephritis

Alport syndrome

Kidney stones


Acute pyelonephritis

Chronic pyelonephritis

Prerenal azotemia

Renal azotemia

Acute tubular necrosis

Postrenal azotemia

Renal papillary necrosis

Renal cortical necrosis

Chronic kidney disease

Polycystic kidney disease

Multicystic dysplastic kidney

Medullary cystic kidney disease

Medullary sponge kidney

Renal artery stenosis

Renal cell carcinoma


Nephroblastoma (Wilms tumor)

WAGR syndrome

Beckwith-Wiedemann syndrome

Bladder and urethral disorders

Posterior urethral valves

Hypospadias and epispadias

Vesicoureteral reflux

Bladder exstrophy

Urinary incontinence

Neurogenic bladder

Lower urinary tract infection

Transitional cell carcinoma

Non-urothelial bladder cancers

Renal system pathology review

Congenital renal disorders: Pathology review

Renal tubular defects: Pathology review

Renal tubular acidosis: Pathology review

Acid-base disturbances: Pathology review

Electrolyte disturbances: Pathology review

Renal failure: Pathology review

Nephrotic syndromes: Pathology review

Nephritic syndromes: Pathology review

Urinary incontinence: Pathology review

Urinary tract infections: Pathology review

Kidney stones: Pathology review

Renal and urinary tract masses: Pathology review


Vesicoureteral reflux


0 / 8 complete

USMLE® Step 1 questions

0 / 2 complete

High Yield Notes

7 pages


Vesicoureteral reflux

of complete


USMLE® Step 1 style questions USMLE

of complete

A 30-year-old primigravida woman at 24 weeks of gestation comes to the office for a routine prenatal evaluation. The pregnancy has been uncomplicated, and she has been compliant with prenatal care. She takes vitamins as needed. Family and medical history are unremarkable. She did not have prior abortions or miscarriages. During ultrasound examination of the fetus, male external genitalia are visible, as well as bilateral hydronephrosis. An amniotic fluid index is equivocal. Which of the following is most likely the cause for the abnormal findings?  

External References

First Aid


Vesicoureteral reflux p. 549


Content Reviewers

Rishi Desai, MD, MPH


Tanner Marshall, MS

Vincent Waldman, PhD

Vesico refers to bladder and ureteral refers to the ureter - so vesicoureteral reflux means that urine is refluxing or getting backed up.

Normally, urine flows in one direction - it starts in the kidneys, goes down into the bladder and when the bladder is full, urine flows out of the body through the urethra.

In vesicoureteral reflux, there is some obstruction in that path which causes pressure to build up and a current of urine actually pushes backward from the bladder into the ureters and kidneys.

There are two types of vesicoureteral reflux, or VUR. Primary vesicoureteral reflux is the most common type and happens when a child is born with a defect at the ureterovesical junction, which is the spot where the ureter enters the bladder, which also acts as a valve preventing urine from pushing back from the bladder into the ureter.

Normally about two centimeters of the ureter sticks into the bladder wall, allowing urine to flow into the bladder, but as the bladder fills up and stretches, it also stretches that section of the ureter and presses it against the top of the bladder, causing the ureter to close shut.

If the tube isn’t long enough though, that small piece of the ureter doesn’t stretch very much, and it stays open even when the bladder fills with urine. In that situation, as the bladder pressure builds with more urine, it starts to go back up the ureters.


Vesicoureteral reflux is a condition where the pressure in the urinary outflow tract increases and urine gets pushed back up into the ureters or kidneys. There are two types of vesicoureteral reflux: primary and secondary.

Primary vesicoureteral reflux is the most common type and happens when a child is born with a defect at the ureterovesical junction, which acts as a valve preventing urine from pushing back from the bladder into the ureter. Secondary vesicoureteral reflux is caused by an acquired condition or disease that causes a blockage in the urinary tract.

The disease often leads to urinary tract infections that can cause renal inflammation and scarring. Treatment options depend on the severity of the condition and may include antibiotics to prevent infections and surgery to correct the reflux.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 8E" McGraw-Hill Education / Medical (2018)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Guidelines for the medical management of pediatric vesicoureteral reflux" International Journal of Urology (2020)
  6. "Vesicoureteral Reflux, Reflux Nephropathy, and End-Stage Renal Disease" Advances in Urology (2008)
  7. "Vesicoureteral Reflux" Journal of the American Society of Nephrology (2008)

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